Bloodletting-induced cardiomyopathy: reversible cardiac hypertrophy in severe chronic anaemia from long-term bloodletting with cupping.

Cardiac hypertrophy in a patient with severe iron deficiency anaemia associated with long-term bloodletting using cupping, called 'puhang' in oriental medicine, is discussed using chest electrocardiographic and radiographic images. With iron supply, the patient showed remarkable improvement of cardiomegaly, which is a unique feature of chronic severe iron deficiency anaemia.